Management of Posterolateral Corner Injury in the Multiligament Injured Knee

The primary stabilizers of the posterolateral corner (PLC) are the fibular collateral ligament (FCL), the popliteus tendon (PLT), and the popliteofibular ligament (PFL), and they all serve as primary stabilizers against external rotation and varus opening forces. Historically, the PLC has been considered complex and was even termed “the dark side of the knee”; however, a systematic approach by studying the anatomy and biomechanics has improved our understanding. These studies have led to development of anatomic-based reconstructions which improve knee function and patient outcomes. It is important to recognize these injuries and treat them early because missed or untreated injuries can lead to poor function, failure of reconstructed cruciate ligaments. Furthermore, studies have demonstrated that anatomic reconstructions are superior to repairs for torn PLC structures; therefore, reconstruction for grade III injuries should be attempted early when possible.